The Berkshire West integrated care system will continue to work towards delivery of the NHS England Five Year Forward View and to identify additional clinical work streams that will deliver tangible improvements for patients as well as financial sustainability. The plan for 2018/19 includes:
- Outpatient transformation: There are increasing demands on outpatient services with growth in referrals year on year putting demands on outpatient facilities, waiting times and clinicians. This increasing growth in referrals and activity requires a review of the approach to outpatients to ensure that future ways of working are safe and cost effective. The overall aim is to provide the best patient experience, with treatment where it is needed and delivered in the most appropriate way, such as care closer to home via community facilities or through the use of technology as an alternative to traditional face to face appointments.
- Population health management: Population health management is the bringing together of patient data across multiple health information technology resources, the analysis of that data into a single patient record, and the actions through which care providers can improve clinical patient outcomes. Berkshire West’s approach to population health management will ensure it is better placed to understand the needs of the local population as a whole and identify those most at risk of chronic disease, such as diabetes or heart disease, so that appropriate care can be offered as early as possible.
- Shared bed modelling: This project aims to ensure patients receive the right care in the most appropriate place, thus reducing delays in discharge.